COMPLICATIONS OF TARSOCONJUNCTIVAL CRAFTS

The authors reviewed 44 tarsoconjunctival grafts performed from 1983 t o 1993 to determine the nature and severity of complications related t o these grafts. Follow-up ranged from 3 weeks to 10 years, with a mean of 23 months. The complications were categorized as none, minor, or m ajor. A complication was deemed major if it required a second surgical procedure for treatment. Eleven percent (5/44) of patients had major complications, including marked upper lid retraction after upper lid r econstruction (1), wound dehiscence (2), cicatricial ectropion (1), an d excessive lower lid laxity (1). Seventy-three percent (32/44) of pat ients had minor complications. Minor complications included trichiasis (5), notching of the donor and/or recipient lid margin (9), mild lid retraction (3), contour deformity (2), granuloma (2), prolonged edema or erythema (4), symblepharon (1), mild ectropion (2), punctate kerati tis (1), minimal ptosis (1), and epiphora (1). Sixteen percent (7/44) had no complications. Despite the frequent minor complications and the occasional major complications, the use of free tarsoconjunctival gra fts remains a valuable procedure in the surgeon's armamentarium for re construction of major eyelid defects. Knowledge and early recognition of the possible complications may result in better patient care.